Use of disinfection cap helps reduce CLABSI rate

Central line-associated bloodstream infections dropped by 52% when an alcohol-impregnated disinfection cap was used instead of a standard scrubbing protocol, according to a study.

A team of researchers from NorthShore University HealthSystem in Illinois conducted a study of adult patients to determine the efficacy of 70% alcohol-impregnated disinfection caps over the standard cleaning protocol, which involves scrubbing the catheter hub with an alcohol disinfectant wipe prior to accessing the lines.

In a three-phased study, contamination rates among 799 patients sampled from three hospitals declined from a baseline of 12.7% using the standard cleaning protocol to 5.5% when the disinfection cap was used, and increased back to 12% when the intervention was removed and the standard protocol was reinstated.

Infection rates at four hospitals declined from a baseline of 1.43 per 1,000 line days to 0.69 during the intervention, and returned to 1.31 per 1,000 line days when the intervention was suspended.

The researchers estimated that system-wide implementation of the disinfecting caps would prevent 21 CLABSIs and four deaths each year.

"Catheter hub decontamination requires a thorough scrub, and compliance varies," the authors wrote. "The approach of using a continuously applied alcohol-impregnated sponge as a cap on the hub for a standard approach to catheter care may eliminate the problem of teaching healthcare providers one additional disinfection process they need to use as part of their busy patient care schedule."